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“Are You My Nurse?” The Importance of Claiming Professional Identity

This post is from CHMP Graduate Fellow, Amanda Anderson, RN’s blog, This Nurse Wonders. More frequently than not, Amanda writes toward her simple goal, “I want nurses to start talking.” Here, she muses on the importance of using titles in health care.

By neglecting to title ourselves, we allow others to paint us as whatever stereotype is the most convenient, or the most useful. Work by Richard Prince, Registered Nurse. 2002.

By neglecting to title ourselves, we allow others to paint us as whatever stereotype is the most convenient, or the most useful. Work by Richard Prince, Registered Nurse. 2002.

In their book, From Silence to VoiceBernice Buresh and Suzanne Gordon discuss the silence of the nursing profession in the media. Chapter after chapter, they expose how reluctant we are to share with the public the details of our job, how we hide behind the stereotypes and discriminations of our profession, and, most importantly, what we lose because of this silence.

I’ve picked it up again, after my first read years ago. It’s funny, to see the notes I scribbled in the margins then. Lots of ?!?!? and WHY DO WE DO THIS?! It’s not so funny, seven years later, to realize how much remains unchanged.

Over the weekend, on a bus ride back from a quick DC trip to see my sister, I read the chapter entitled, “Presenting Yourself As A Nurse.” I remember reading this so long ago, thinking their recommendation to introduce myself as “Nurse Anderson,” while expecting other providers to address me as such, seemed kind of dated. Do I want to be called Nurse Anderson by interns who are now, a growing handful of years younger than me? Kind of feels like being called “ma’am” by a stranger in the grocery store.

But they make a good point: the discrepancy between doctor’s and nurses title usage – doctor’s always introduce themselves as such, while nurses are often the mysteriously untitled profession – solidifies physician-identity in the mind of the patient and, ultimately, the public. Sure, when chatting at the nurses station, first-name basis between providers is fine, but in introductions to patients or family, first-name-only-nurses surrender their professional identity.

I floated to endoscopy yesterday. Assigned to man the recovery room with two other nurses, I pondered this identity challenge, and decided to conduct some experiments. As sleepy patients wheeled in from their various procedures, I’d give them a little shake, and with Buresh and Gordon in my brain, I’d say, “Hello! I’m Amanda, I’m a nurse,” to their crusty-eyed, confused gaze. Just coming out of twilight anesthesia, many marveled at the simplicity of my greeting, and its ability to provide them with much needed context. Not one of them asked me where they were, or who I was, and honestly, it felt good to title myself openly.

I used my new, identity-charged greeting all shift – when I called the pharmacy for medications, I said, “Hi! I’m Amanda, I’m a nurse calling from endoscopy.” When I phoned the operator to connect me to another unit, “Hi! I’m Amanda, I’m a nurse,” came easily, and I was shocked at how clearly it was received, and how many clarifications it saved me.

While I fluidly added my title to my introductions, making them direct and clear, I was amazed at how muddled and ambiguous my co-nurse’s greetings sounded in contrast. Smiling down at her sleepy patients, she said, time and time again: “Hello! I’ll be taking care of you.” Huh? Where am I? Who are you? Were the most common responses.

I’ll admit, I’ve said this phrase countless times. But hearing it in the shadow of Buresh & Gordon’s recommendations, made me wonder why we nurses think it’s acceptable – are we ashamed to call ourselves “nurse,” or do we just not recognize how important our title is?

In an era where nurses no longer have a recognizable image, where we all work in different capacities and at different levels, and where our education and practice is frequently called into question, it is becoming clearer and clearer how closely-linked the act of verbal title distinction is to our professional success. By neglecting to state who we are - the nurse – we give up control of our identity, our rights to our work, our voice as a profession; our silent namelessness allows us to become whatever stereotype is the most convenient, or the most useful.

My titling experiment cemented itself into forever-practice around three pm, when I prepared to call report on a patient who was returning to her bed on the floor. I asked the patient if she knew her nurse’s name, to speed up the phoning process. She told me it was Samantha, who I requested when I phoned the unit. “Oh, Samantha is the nurse’s aide, I’m Jane. I’m the nurse.” Damn.

All that work, all that time, all that expertise, all that knowledge, and the patient still has no clue who we are. A simple switch of the tongue might be a start to something big, nurses. While I may not introduce myself as Nurse Anderson just yet, I’ll definitely be seasoning my communications with my title from here on out.

Healthstyles Today: Medicare and a New Online Mental Health Service

wbaiToday on Healthstyles on WBAI, 99.5 FM (www.wbai.org) at 1:00, producer and moderator Diana Mason, RN, hosts a program that opens with HealthCetera, a health news updated, followed by a discussion of Medicare by c0-producer Liz Seegert with Stacey Sanders, Federal Policy Director of the Medicare Rights Center, a national non-profit organization that helps older adults and people with disabilities to get health coverage through counseling, advocacy, educational programs and public policy initiatives.

The program then airs an interview that Mason did with Jen Hyatt, founder and CEO of Big White Wall, an online service that helps individuals get support, take control and feel better, by creating an anonymous and safe space to share and access personalized pathways to recovery via a supportive online community and proactive self-management services, facilitated by experienced guides. Big White Wall was named a High Impact Innovation by the UK National Health Service and as the best eHealth solution developed by an SME (Small and Medium Sized Enterprise) across the European Union.

You can listen to the program by clicking here:

Healthstyles if sponsored by the Center for Health, Media & Policy at Hunter College, City University of New York.

Katie on Nursing

KatieI was pleased to be interviewed by Katie Couric on her program, “Katie”, that aired today. She also interviewed filmmaker Carolyn Jones (pictured here with Katie) about her documentary, The American Nurse, and three of the nurses featured in her documentary. Thanks to Katie for doing the program!

Healthstyles: news on health & technology

Healthstyles producers has been invited to provide regular news updates to WBAI 99.5 FM producer and host Michael G. Haskin’s Morning Show.  We officially launch this series, called HealthCetera,  Thursday, July 17.  This news segment reports on health and technology. Hear about Google and Novartis joint venture creating a smart contact lens, news reported by health economist Jane Sarasohn-Kahn‘s on her site, HEALTHPopuli, on trends in mhealth, and finally the increasing role of telemedicine as reported by Bloomberg news and summarized by Kaiser Health News. You can listen here HealthCetera

healthtech

Waste Not, Water Not

Yesterdays New York Times reported on the link between poor sanitation and malnutrition in children in India. Noting that prior studies of child malnutrition fail to even mention sanitation, the article points out that about half of the population of India does not have or use toilet or latrines, with some people (mostly men, according to the article) preferring to defecate outdoors. As a result, children are exposed to disease agents transmitted in fecal matter. No matter how much the children eat, they are unable to gain weight and draw upon the food’s nutrition. One million children die before age 5, and 65 million of those who do survive have permanently stunted growth and brain development.

The link between malnutrition and sanitation is based upon a study published by the Research Institute of Compassionate Economics (I like that title a lot), or RICE, “a nonprofit research organization, dedicated to understanding the lives of poor people, especially young children, in India, and to promoting their well-being.”  Calling for a “Latrine Use Revolution“, RICE argues that simply building more toilets or latrines is not the answer. The government of India needs to mount a media campaign to educate its population on the importance of confining human waste to special areas to avoid the spread of disease.

We assume that people should have the right to live healthy lives through a basic level of sanitation, so it’s easy to be critical of India. But how do we respond to the right to live healthy lives in our own country?

Recently, the right of people living in the U.S. to access water (note that I’m not even saying “clean water”) has come into question. Some weeks ago, Detroit began to cut off water to residents who owe $150 or more in water bills, for a total of over $90 million in back payments.  People are creative, particularly when it comes to survival; and so some of those with no water were able to do an “illegal” hook up to be able to drink and wash. Yesterday, the city announced that it had fined 79 residents a total of over $21,000 in fees for such hook ups. The city charges $250 to restart water to a home the first time–a fee that increases with each delinquent payment and shut off. Such fees seem to ignore that people can’t pay their bills because they are poor.

Last year, Peter Brabeck-Letmathe, chairman of the board and former CEO of Nestle, said in a YouTube video that water is not a public right and should be privatized. In the video, he goes on to say, “We’ve never had it so good, we’ve never had so much money, we’ve never been so healthy. we’ve never lived as long as we do today. We have everything we want and still we go around as if we were in mourning for something.”  Perhaps he should visit Detroit and talk with the people who have no water because they are too poor to pay their water bills. Or he could visit India and speak to the mothers of the children who are dying from a lack of sanitation. Life is so good for “us”.

Diana J. Mason, PhD, RN, FAAN, Rudin Professor of Nursing

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